Listeria monocytogenes peritonitis in cirrhotic patients: first description in Brazil / Peritonite bacteriana espontânea causada por Listeria monocytogenes em pacientes com cirrose: primeiro relato de caso no Brasil

Two cases of spontaneous bacterial peritonitis (SBP) caused by Listeria monocytogenes in cirrhotic patients are reported. In one of the cases, the microorganism was isolated from pleural effusion and ascites. SBP is a serious and common complication of patients with ascites caused by hepatic cirrhosis and the culture of the ascitic fluid is an important tool for the diagnosis and for the more appropriate treatment. Although a third generation cephalosporin has usually been employed for empiric treatment of SBP, it does not provide adequate coverage against Listeria spp. In such cases the use of ampicillin (with or without sulbactam) or sulfamethoxazole-trimethoprim is recommended. The last one is used for secondary prophylaxis, instead of norfloxacin. To summarize, Listeria monocytogenes infection is a rare cause of SBP, whose treatment should be specific for the bacteria.

Foram relatados dois casos de peritonite bacteriana espontânea (PBE) por Listeria monocytogenes em pacientes com cirrose. Em um dos casos isolamos também o agente no líquido pleural. A PBE é uma complicação comum e grave de pacientes com ascite por cirrose e a cultura do líquido ascítico é de grande importância para o diagnóstico e para o tratamento mais adequado. Embora uma cefalosporina de terceira geração seja geralmente utilizada para o tratamento empírico da PBE, ela não oferece cobertura adequada contra a Listeria spp. Nesses casos, recomenda-se o uso de ampicilina (com ou sem sulbactam) ou sulfametoxazol-trimetoprim. Para a profilaxia secundária indica-se o uso deste último, ao invés da norfloxacina. Em resumo, a infecção por Listeria monocytogenes é uma causa rara de PBE e o tratamento específico deve ser administrado.

Papel da atividade física regular realizada durante vários anos na função imune do idoso / Role of regular practice of physical activity over several plus om immune function in the elderly

Para avaliar o efeito da atividade física regular na imunosenescência, comparou-se parâmetros imunológicos de 20 idosos corredores aos de 20 idosos sedentários e 10 jovens sedentários. Os idosos corredores apresentaram resposta proliferativa de linfócitos T a OKT-3 e produção de interleucina-2 maiores do que os idosos sedentários, porém similares aos jovens. Eles apresentaram produção de interleucina-3 menor, mas também semelhante aos jovens. A interleucina-6 sérica deles foi menor do que a dos idosos sedentários. Conclui-se que a prática regular de atividade física por longos anos tem o potencial de desacelerar a imunosenescência / To access the effect of regular physical activity on immunosenescence, the immunological parameters of 20 elderly runners were compared to those of 20 elderly sedentary persons and 10 sedentary young persons. The running elderly subjects presented a higher T lymphocyte proliferative response to OKT-3 and a higher interleukin-2 production than elderly sedentary subjects, but similar to that of young subjects, plus a lower production of interleukin-3, but also similar to that of young subjects. Their serum interleukin-6 was lower than that of sedentary elderly subjects. We conclude that practicing regular physical activity for many years has the potential to decelerate immunosenescence...

Primary biliary cirrhosis and myopathy: an uncommon association

Primary biliary cirrhosis (PBC) is a cholestatic liver disease, which is characterized by a chronic inflammatory destruction of intrahepatic bile ducts. It is a rare disorder whose precise etiology is still to be elucidated. Even though the liver is the principal target of PBC, other organ systems also might be affected. Muscular involvement has rarely been described in this disease, and in the majority of cases, muscular weakness has been interpreted as polymyositis. We report the case of a 48-year-old woman suffering from classic PBC, in association with a myopathy whose histological features are distinct from the cases reported before. We also performed a MEDLINE research for PBC and concomitant muscular diseases